Kornimate/medical-research-clean huggingface dataset:
end growth results for conservative treatment for idiopahitc scoliosis

Conditions: Scoliosis; Adolescence; Scoliosis Idiopathic

Summary: this study evaluates in a prospectively collected multicenter cohort the existence, characteristics and determinants of ebpca, the obtained results and their determinant, the rate of over- and under-treatment and their determinants.

since an evidence-based personalised conservative approach (ebpca) to adolescent idiopathic scoliosis has never been checked, the investigators studied a prospectively collected multicenter cohort with the aim to verify in the different clinical situations 1) the existence, characteristics and determinants of ebpca; 2) the obtained results and their determinant; 3) the rate of over- and under-treatment and their determinants. these results are expected to check the actual evidence in everyday clinic, to provide a benchmark for future studies, and to inform guidelines producers and consequently health policy in high income countries, but also and particularly in low-middle income countries where surgery is difficult due to the high costs, and missing competences and structures.

Eligibility criteria:
inclusion criteria: * diagnosis of adolescent idiopathic scoliosis (ais), * curves between 11 and 45° at start, * risser test between 0 and 2. * since our institute receive many participants for a second opinion, we considered only participants in charge, defined as those who came at least three times to our facilities exclusion criteria: * previous bracing; * absence of x-rays in the 3 months before/after the start and the end of treatment/observation.
improving emergency management of status epilepticus

Conditions: Status Epilepticus

Summary: in the trial the effectiveness of pre-briefing physicians with the current guideline on status epilepticus (se) treatment or a consolidated "one page" guideline regarding quality enhancement of the physician's clinical performances is investigated.

status epilepticus (se) is a life-threatening neurological emergency defined as a state of continuous seizure or multiple seizures without full recovery of sensory, motor and/or cognitive function for at least 30 minutes. to achieve high quality management of se, the american epilepsy society published an evidence-based guideline for the treatment of se, which serves as reference for most national guidelines, but analyses regarding practicability, strict adherence, correct translation into clinical practice, and identification of recommended treatment steps at risk of being modified or missed are lacking. simulator-based studies offer a platform for the design of standardized clinical scenarios that enable detailed investigations regarding the effect of the implementation and practicability of treatment guidelines. this randomized controlled intervention study performed at the simulation center of the medical intensive care units (icus) at the university hospital basel is to investigate the effectiveness of pre-briefing physicians with both the current guideline on status epilepticus (se) treatment or a consolidated "one page" guideline regarding quality enhancement of the physicians' clinical performances.. physicians from different medical specialties and with different duration of clinical experience will be enrolled. participants will be randomly assigned to one of the following three pre-briefing groups: (1) no pre-briefing prior to the simulation training; (2) pre-briefing with the current se treatment guidelines; (3) pre-briefing with the consolidated "one page" se treatment guideline.

Eligibility criteria:
inclusion criteria: * physicians from different medical specialties working at the university hospital basel exclusion criteria: * none

Keywords: guideline for the treatment of status epilepticus antiseizure drugs (asds)
effects of a portfolio diet on nafld in type 2 diabetic patients

Conditions: Diabetes Type 2; NAFLD

Summary: patients with type 2 diabetes and non-alcoholic fatty liver disease will be enrolled. according to a parallel design, the participants will be randomized to a portfolio diet or a monounsaturated fatty acid (mufa)-rich diet (used as control) for 8 weeks. at the beginning and at the end of the trial, the participants will undergo a mri spectroscopy to evaluate fatty liver content. moreover, the participants will undergo a test meal resembling the nutritional composition of the assigned diet to evaluate fasting and postprandial metabolic response.


Eligibility criteria:
inclusion criteria: * type 2 diabetes * non-alcoholic fatty liver disease (evaluated by us) * hba1c \<7.5% * ldl cholesterol \<130 mg/dl exclusion criteria: * hypoglycemic therapy with sodium-glucose cotransporter (sglt-2), pioglitazone and glucagon-like peptide (glp-1) analogues * severe liver and kidney failure * recent cardiovascular events (prior 6 months) * any other acute/chronic disease (anemia, cancer, bpco)
acoustic stimulation paired with body and cortical stimulation for modulating tinnitus

Conditions: Tinnitus

Summary: the purpose of the study is to investigate different stimulation parameters for a new noninvasive approach for modulating the brain that could potentially be beneficial for decreasing tinnitus perception. the new approach is called multimodal synchronization therapy (msync). msync uses a combination of acoustic stimulation played through headphones and low levels of electrical current delivered via electrodes placed on the surface of different body regions. the timing interval between the acoustic and body stimulation is varied in order to cause different types of changes in the brain. in addition to acoustic and body stimulation, noninvasive cortical stimulation will also be presented as part of msync to attempt to further modulate or decrease the tinnitus percept. cortical stimulation will be performed by placing a magnetic coil over a spot on the head and sending a brief magnetic pulse that can travel through the skin and bone to create electrical current inside the head. for this study, different body locations as well as specific timing intervals among acoustic, body, and cortical stimulation will be investigated to identify appropriate parameters that can modulate and potentially decrease tinnitus perception. different msync parameters will be investigated across multiple testing sessions (up to 16 weekly sessions) and the tinnitus percept will be closely monitored throughout the study.

this study is not specifically seeking to treat tinnitus but is designed to investigate various msync parameters that can alter the tinnitus percept. findings from this study will help identify specific msync parameters that can be more effective at decreasing or fully suppressing the tinnitus percept that will be systematically explored in a follow-up study.

Eligibility criteria:
inclusion criteria: * have subjective, non-pulsatile, and bothersome tinnitus * will not start any new tinnitus treatment during the study * ability to give informed consent and understand study objectives in english * willing and able to understand and comply with all study-related procedures exclusion criteria: * substantial hearing loss or hyperacusis that may interfere with the study * medical history of other ear or brain disorders, history of seizures, or currently using any medication or treatments that can cause or increase the chances of seizures * any implanted medical or metal device, such as a pacemaker, aneurysm clip, or cochlear implant * pregnant or currently breast-feeding (we need to give all female subjects a pregnancy test because pregnant females and unborn children need extra protection for their safety) * any handicap that prevents the subject from reliably performing the tests

Keywords: neuromodulation noninvasive plasticity transcranial magnetic stimulation hearing hyperacusis
five, plus nuts and beans for kidneys

Conditions: Chronic Kidney Disease; Hypertension

Summary: this five, plus nuts and beans for kidneys study is a single center, randomized controlled trial with 2 parallel arms testing the hypothesis that delivery of nutritional advice to adopt a dietary approaches to stop hypertension (dash)-like diet and $30/week worth of fruits, vegetables, nuts and beans tailored to personal choices and availability in neighborhood stores, will reduce kidney damage in african americans with hypertension and chronic kidney disease.

this study will test the effectiveness of dietary advice delivered by a study coach and assistance with weekly online ordering of $30/week worth of potassium rich foods delivered by a local grocer to a community location for reducing urinary albumin excretion among african americans with hypertension and chronic kidney disease. participants will be recruited from primary care clinics in baltimore, md. 150 african american adults diagnosed with hypertension and with mild/moderate chronic kidney disease based on the presence of albuminuria will be randomly assigned to one of two arms for 12 months. there are 2 phases of the study. in phase 1 (months 1-4), one study arm will consist of minimal guidance from the study team and a weekly allowance of $30 dollars to purchase food and drinks of their choosing from a local grocer. during phase 1, the second arm of the study will receive dietary guidance from the study coach and assistance with ordering and purchasing $30/week worth of high potassium foods from the same local grocer. in phase 2 (months 5-12) neither study arm will receive a food allowance, however the second arm will receive telephonic visits and dietary advice from the study coach.

Eligibility criteria:
inclusion criteria: * self-identified african american race * age 21 years or older * clinical diagnosis of hypertension and have a urine albumin-creatinine ratio (acr) of ≥30 mg/g with or without estimated glomerular filtration rate (gfr) 30-59 ml/min/1.73m2. * must be under regular care with their johns hopkins community physicians (jhcp) or johns hopkins outpatient center (jhoc) physician (seen within the past 12 months). * must have a systolic blood pressure of \<=160 mmhg and a diastolic blood pressure of \<=100 mmhg (average of two visits) * be on stable doses of antihypertensive medications for a minimum of two months prior to randomization. exclusion criteria: * cardiovascular (cv) event within 6 months * chronic disease that might interfere with trial participation (e.g. stage 4 or 5 chronic kidney disease, estimated glomerular filtration rate \<30 ml/min/1.73m2) * unwillingness or inability to adopt a dash-like diet * consumes over 14 alcoholic drinks per week * poorly controlled diabetes (hemoglobin a1c \>9%). * patients with a serum potassium \>4.6 milliequivalent (meq) /l45 * urine acr ≥ 1,000 mg/g

Keywords: chronic kidney disease hypertension albuminuria african americans
reducing depression in dementia caregivers

Conditions: Depression

Summary: the purpose of this study was to develop and examine the initial impact of a distance-based intervention for female family dementia caregivers. as stated in the original proposal, the primary hypothesis of the study was that family caregivers who participated in the video intervention would show greater reduction in psychological distress (i.e., on measures of depression and emotional distress following problematic patient behaviors) compared to those in the basic education condition, and that this effect would be maintained over time (3 and 6 months post-tx).

family caregivers of individuals with dementia commonly report depressive symptoms, along with other forms of emotional distress. this study compared the effectiveness of two home-based interventions to reduce levels of depressed, anxious, and other negative moods in women living with a family member with dementia. eligible caregivers were randomly assigned to participate in either a video/workbook/telephone coaching intervention, or to a basic education condition consisting of a workbook and supportive telephone calls. participants were evaluated for psychosocial distress after treatment, and at 3- and 6-months following the end of intervention.

Eligibility criteria:
inclusion criteria: * caregiver and dementia pt live in the same home * resident of following states: il,in, io, ks, mi, mn, mo, nb,wi exclusion criteria: * insulin dependent diabetes * thyroid disease

Keywords: caregiving dementia alzheimer's depression technology treatment
bileacid malabsorption and glp-1 secretion

Conditions: Bileacid Malabsorption

Summary: the aim of this study is to examine the influence of bam on postprandial glp--1 secretion and glucose homeostasis, both with and without bile acid sequestration.


Eligibility criteria:
inclusion criteria: * northern european origin * normal haemoglobin * age above 18 years and below 70 years * informed and written consent * bmi \> 23 kg/m2 and \< 35 kg/m2 * normal fasting plasma glucose (fpg) \< 6.5 mm) and glycated haemoglobin (hba1c) \< 48 mmol/mol exclusion criteria: * liver disease (alanine aminotransferase (alat) and/or serum aspartate aminotransferase (asat) \>2 times normal values) or history of hepatobiliary disorder * gastrointestinal disease (except bam), previous intestinal resection, cholecystectomy or any major intra-abdominal surgery * first-degree relatives with diabetes * nephropathy (serum creatinine \>150 µm and/or albuminuria * treatment with medicine that cannot be paused for 12 hours * hypothyroidism or hyperthyroidism * treatment with oral anticoagulants * active or recent malignant disease * any treatment or condition requiring acute or sub-acute medical or surgical intervention * lack of effective birth control in premenopausal women * any condition considered incompatible with participation by the investigators
intensive cancer screening after cryptogenic stroke

Conditions: Occult Cancer

Summary: the incognito pilot trial is a single centre pilot prospective randomized open-label blinded endpoint (probe) trial to assess the feasibility of a full-scale randomized trial to determine whether an occult cancer screening strategy of fdg pet/ct in addition to usual care increases the number of occult cancers diagnosed after screening compared to usual care cancer screening alone in patients with cryptogenic stroke.


Eligibility criteria:
inclusion criteria: * adults ≥18 years * presenting to the ottawa hospital stroke prevention clinic or the ottawa hospital neurovascular unit with a first cryptogenic ischemic stroke after advanced evaluation as per american heart association guidelines and saver approach (maximum 3 months after stroke) * patient or delegate willing and able to provide informed consent. exclusion criteria: * contraindications to fdg pet/ct (pregnancy or unable to lie still in bed for 20 minutes) * active cancer or previous cancer diagnosis (other than basal or squamous cell carcinoma of the skin)

Keywords: cryptogenic stroke
multimodal imaging analysis, sd-oct and oct angiography, retinal variations observed in dialysis patients

Conditions: Renal Failure

Summary: little knowledge exist on the short and long-term ophthalmological effect of the dialysis. some studies stated a variation of the thickness subfoveal choroidal before and after a session of dialyse as well as variations of the coat of optical fibers measured in oct. the optical coherence tomography angiography oct is a not invasive imaging technique which is now a part of examinations of investigation in imaging of retina. this technique allows to study the retinal macula vascularization without injection of contrast agent and thus allows to deepen the knowledge in medical domains where the exploration was to limited because of the invasive character of the examinations. the hypothesis of this project is that hemodynamic change during the hemodialysis may lead fine variations of the retinal vascularization in the short-term (the day of the dialysis) but also in the longer term (over 1 year).


Eligibility criteria:
inclusion criteria: * indication of treatment by hemodialysis * first session of dialysis * hemodialysis planned for 1 minimum year exclusion criteria: * particular ophthalmological histories: vitreo-retinal surgery, strong nearsightedness, chronic glaucoma * unaffiliated in a national insurance scheme
52 week trial of liraglutide in type 1 diabetes

Conditions: Type 1 Diabetes

Summary: to our knowledge, no trial has specifically studied the effect of liraglutide combined with a basal/bolus insulin regimen in type 1 diabetes in a cross-over, double-blind, unicentric model. moreover, the potential impact of a glucagon-like peptide-1 agonist on measures of abdominal fat (assessed by ct scan), insulin sensitivity (assessed by the gold standard euglycemic-hyperinsulinemic clamp) and satiety sensations have not been evaluated in this population. hypothesis overweight participants with type 1 diabetes on liraglutide/insulin treatment will present improved glucose control with decreased hba1c, decreased fasting and mean weekly glucose concentrations and glycemic excursions as well as increased insulin sensitivity compared to participants on placebo/insulin treatment. participants with liraglutide/insulin treatment will also present improved endothelial function, lower body weight, central adipose tissue assessed by ct scan and higher satiety sensations assessed by visual analogue scales.

participants will be submitted to this double-blind cross-over protocol of 52-week use of liraglutide/placebo.

Eligibility criteria:
inclusion criteria: * type 1 diabetes non smoker bmi superior or equal to 25 diabetes duration superior or equal to 5 years exclusion criteria: * diabetic complication hba1c superior or equal to 8.5% cancer acute or chronic pancreatitis

Keywords: type 1 diabetes overweight insulin liraglutide
cancer anesthesia and frailty

Conditions: Cancer; Anesthesia; Fragility

Summary: subjects undergoing cancer related surgery at the fondazione irccs istituto nazionale dei tumori - milano will be consecutively recruited. data regarding presence of co-morbidities, frailty, cancer staging, and inflammatory status (crp protein measurement) will be collected preoperatively. intra-operative data collection will comprehend type and duration of surgery, kind of anesthesia, complications. in-hospital mortality will be considered as the primary endpoint, while secondary outcome measures will be duration of hospital stay and admission to intensive care.

a prospective data collection of pre-intra and postoperative variables will be collected in a cohort of subjects undergoing cancer relate surgery at the fondazione irccs istituto nazionale dei tumori, milano. before surgery subjects will be stratified before surgery according to the following three main clusters: 1) systemic inflammation: baseline levels of c reactive protein; 2) cancer staging: tnm will be taken into account, together with the type of cancer, previous radio or chemo therapy, and planned/performed surgical procedure; 3) frailty: subjects will be stratified according to their overall status, taking into account elements of frailty. co-existing diseases such as diabetes, hypertension, cardiac heart failure, acute myocardial infarction, chronic obstructive disease/asthma, kidney or liver disease (past or present) will be considered. functional status will be assessed by means of asa, ecog status and possum scores. frailty will be explored using the mfi and g8 score, the who scale, and considering age. absolute bmi and loss of weight will be used to assess malnutrition. during surgery duration and type of surgery, kind of anesthesia and intra-operative complications will be considered. after surgery hospital mortality, length of stay, and admission to intensive care will be considered as outcome measures. major complications, such as myocardial infarction, arrhythmia, cardio circulatory arrest, shock, stroke, pulmonary embolism, kidney failure, delirium, pneumonia or ssi will also be considered.

Eligibility criteria:
inclusion criteria: subjects undergoing cancer related surgery at the fondazione ircss istituto nazionale dei tumori, milano exclusion criteria: day case surgery
benefit of spectral information in patients suspected for lung cancer

Conditions: Lung Neoplasm Malignant

Summary: purpose the aim of the study is to investigate the utilization of photon counting ct (pcct) and the spectral information provided to determine the impact of spectral information on follow-up examinations. as secondary aims we will compare conventional ct, ct + 18flouro-deoxy-glucose (18f-fdg) positron emission tomography (pet) and pcct + 18f-fdg pet for the tumor-node-metastasis (tnm) staging of lung cancer patients. pcct with and without spectral information to assess the need for additional work-up,tnm classification, and sensitivity/specificity for malignant lesions. patients will be randomized for reading with or without spectral information available within a clinical setting. the clinical readings are performed as a structured reports of all significant findings. including both malignant and benign findings. furthermore, in case additional follow-up/work-up is needed based on the guidelines on incidental findings by the american college of radiology (acr), this will be reported as well. if lesions suspicious of pulmonary malignancy is present, a provisional tnm classification is provided based on the scan findings. after 3 months, the patient record is reviewed where additional examinations that can be attributed to the pcct scan are recorded. the financial impact is calculated by a health economist based on the findings. pet/ct, conventional ct and pcct combined with pet will be assessed retrospectively for comparison. endpoints are number of supplementary examinations and cost savings. sensitivity and specificity for any malignant finding. the t, n and m stages are assessed separately as diagnostic measures by the mcnemar's test with a reference standard from the danish lung cancer register. the number of malignant lesions will be determined by reviewing the patient records incl. pathology assessment if available 12 months after inclusion of the last patient.


Eligibility criteria:
inclusion criteria: * patients suspected of lung cancer refered to copenhagen university hospital as per the guidelines from the danish national health authorities from either the general practitioner or from the department of pulmonology. * informed consent exclusion criteria: * patients who cannot tolerate intravenous iodinated contrast * already verified lung cancer from another institution * comorbidities that exclude the patient from receiving treatment * lack of reference standard in the form of either histology or follow-up * known extrapulmonary malignancy * technical limitations within the scans/reconstructions * other

Keywords: computed tomography spectral ct